在不同ECMO模式下,聚米辛B的药理动力学变化和影响因素
Mi Xu1, Na Chen2, Yong-Wei Yu1
1Department of Critical Care Medicine, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, People's Republic of China.
Infection and drug resistance
|December 30, 2024
概括
研究了在体外膜氧化 (ECMO) 期间的多素B水平. ECMO流量和持续的替代疗法影响了Polymyxin B的药理动力学,影响了细菌清除.
科学领域:
- 药理动力学 药理动力学
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
背景情况:
- 身体外膜氧化 (ECMO) 支持的持续时间增加,增加了细菌耐药性的风险.
- 聚米辛B (PMB) 治疗耐药性感染,但其药理动力学 (PK) 可以在ECMO期间发生变化,冒着错误剂量的风险.
- 在ECMO期间了解PMB PK对于有效治疗耐药细菌感染至关重要.
研究的目的:
- 为了研究在ECMO过程中波利米辛B (PMB) 药动力学参数的变化.
- 为了确定影响PMB水平的因素,在静脉或静脉动脉ECMO患者.
- 为了将PMB度与ECMO患者的细菌清除相关联.
主要方法:
- 一项前性药理动力学研究,涉及11名ECMO患者的耐药细菌.
- 在稳定状态下,在氧化器前后测量PMB度.
- 使用非线性混合效应建模和分析微生物培养结果,开发一个人群PK模型.
主要成果:
- 在氧化器之前和之后的PMB度没有显著差异.
- 一个两部分的模型描述了PMB PK,ECMO流量影响清除 (CL) 和CRRT影响中央体积.
- 较高的平均稳定状态度 (Css,avg) 与成功的细菌清除相关.
结论:
- 在ECMO氧化器中,PMB度稳定.
- 持续置换疗法 (CRRT) 可能会改变ECMO患者的PMB药理学.
- 建议对PMB进行治疗药物监测,以优化ECMO患者的临床结果.
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